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Makihisa orchestrated the destruction of the Nanaya clan utilizing Kouma Kishima, taking in Shiki due to his son having the same name. Due to the effects of his Inversion Impulse, he repeatedly raped Kohaku over a long period of time to make use of her innate abilities to sooth his mind, severely affecting her psyche.
Before the events of the game, he was murdered by SHIKI, leading to the full awakening of Roa.

Makahisa, like all of the Tohno family, possesses demonic blood, which caused in him bipolar disorder along with schizophrenia. During the massacre of the Nanaya, he displays abilities to that of SHIKI Tohno, able to solidify blood from inflicted wounds and use it as a sword-like weapon.

Makihisa Tohno [Person's name]
Akiha and SHIKI's father. He took in Kohaku and Hisui as tools to restrain his Tohno blood, and adopted Shiki for his own amusement. He was a mischievous prankster who diligently held on to his private papers. He had a strong, self-indulgent feeling of being victimized, and you could probably say that it was his weakness that invited tragedy into the Tohno family.
In order to protect his family (blood relatives) and solidify the Tohno's position he forged connections with the demon hunter organization, which was locked in a cold war with the demon hybrids at the time. By entering into a cooperative relationship with the demon hunters, he was able to gain sovereignty over the entire Misaki City region.
However, he was still unable to control his dread toward Nanaya Kiri, the bloodthirsty killer he saw as a youth while serving under a certain old man. So, after consolidating his power, he launched a surprise attack on the Nanaya village and completely wiped them out.
As for how he died, that was covered in the main story.
It was karmic retribution, an end appropriate for one who was in no way a bad person, yet caused so much harm.